Systematic Review of Preventive Interventions for Children's Mental Health: What Would Work in Australian Contexts?

Abstract

In childhood, mental health problems primarily consist of behaviour and emotional problems. These affect one in every seven children (i.e. 200 000 in Australia). Left untreated, up to 50% of preschool problems continue through the childhood years. Because of their high prevalence, population-based approaches will be needed to reduce their associated burden. The aim of the present study was therefore to identify evidence-based preventive interventions for behavioural and emotional problems of children aged 0-8 years. Randomized controlled trials of preventive interventions for behavioural and emotional problems were located by searching standard clinical databases and systematic reviews. The authors determined which programmes were effective and ineffective, dividing the effective programmes into those with high or low risk of trial bias. Among effective programmes, the most promising for delivery in Australian contexts were identified, selected for their strength of evidence, sample comparability to Australia's population, and programme compatibility with Australia's service system. Around 50 preventive interventions have been evaluated in randomized controlled trials. Most targeted children's behavioural problems, and a few targeted emotional problems. Three US programmes have the best balance of evidence: in infancy, the individual Nurse Home Visitation Programme; at preschool age, the individual Family Check Up; at school age, the Good Behaviour Game class programme. Three parenting programmes in England and Australia are also worthy of highlight: the Incredible Years group format, Triple P individual format, and Parent Education Programme group format. Effective preventive interventions exist primarily for behaviour and, to a lesser extent, emotional problems, and could be disseminated from research to mainstream in Australia, ensuring fidelity to original programmes. Future research should develop programmes targeting emotional problems, and replicate effective programmes for behaviour problems in quality population translation trials. Randomized trial methods in staged roll-outs can determine population cost-benefits for children's mental health without delaying dissemination.

La prévention des difficultés de comportement chez les enfants du préscolaire : une recension des caractéristiques des programmes probants

“…www.erudit.org Introduction L'apparition précoce de difficultés de comportement chez les jeunes enfants est un phénomène particulièrement préoccupant et les politiques en la matière recommandent la mise en place d'interventions préventives efficaces (Institut national de santé publique du Québec, 2010). Plusieurs programmes d'intervention ont été évalués, certains au Canada (Tremblay, Pagani-Kurtz, Mâsse, Vitaro, & Pihl, 1995), en Angleterre (Bunting, 2004) et en Australie (Bayer et al, 2009), mais la grande majorité provient des États-Unis (Groark, Mehaffie, McCall, & Greenberg, 2006). Ces évaluations ont permis d'identifier les interventions probantes et certaines caractéristiques associées à l'efficacité des services offerts.…”

“…Cependant, chez certains enfants, le niveau de comportements agressifs reste élevé. Ces difficultés ont tendance à rester stables dans le temps si elles ne sont pas traitées et constituent le facteur qui prédit le mieux les comportements antisociaux à l'adolescence (Broidy et al, 2003).On évalue en effet que les difficultés de comportement vont perdurer chez 50 % des enfants qui ont ce problème à la maternelle (Bayer et al, 2009;Tremblay, Pihl, Vitaro, & Dobkin, 1998).…”

Evaluation of the Implementation of a Preventive Program for Children in Brazilian Schools

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Prevention-based approaches to social policy: The case of early childhood development

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